Effect of play therapy on preschool children who are receiving injections

The purpose of this study was to determine if play therapy using injection equipment and doll play would reduce measured anxiety in preschool children when they received injections. Little controlled nursing research has been conducted prior to this study to determine the effects of the play intervention on children who were receiving injections. The focus was on healthy, normal preschoolers who were receiving immunization in the clinical setting. Data collection occurred in three Pediatricians' offices over a three-month period. The Palmar Sweat Print (PSP) developed by Silverman and Powell in 1944 was used to measure anxiety. The PSP photometrically measures the sweat volume on the palmar surfaces of the fingers. There were 40 subjects in the experimental group and 32 in the control group. Three Palmar Sweat Prints were obtained for each subjects: 1) one as a baseline reading; 2) one after an explanation concerning the purpose for, nature of, and location of injections for subjects in the control group, and after this same explanation and doll play with the injection equipment for subjects in the experimental group; and 3) one after the child had received his immunization by the investigator. It was expected that the prints of for the control group would either remain the same, increase, or decrease slightly. It was expected that the prints for the experimental group would significantly decrease on the second and third readings after they play therapy. Sixteen subjects were excluded from study because they did not cooperate. The Palmar Sweat readings were analyzed separately for this 16 uncooperative subjects. A two-way analysis of variance revealed there was no difference between the two groups on the readings, and that there was no interaction between the two groups and the readings. The one significant finding (F=10.9. p<.01) was that all three Palmar Sweat Print readings were found to be different. These findings indicate the measures of autonomic nervous system activity (PSP readings) diminished over the time period studied, and that the play therapy intervention did not have any significant effect in reducing the measured anxiety. Speculations about the findings are discussed, and recommendations for future studies are presented.